Melissa Angeline Durand MD, Presenter: Nothing to Disclose

Regina J. Hooley MD, Abstract Co-Author: Nothing to Disclose

Madhavi Raghu MD, Abstract Co-Author: Nothing to Disclose

Jaime Lynn Geisel MD, Abstract Co-Author: Consultant, Siemens AG

Liva Andrejeva-Wright MD, Abstract Co-Author: Nothing to Disclose

Reni Simov Butler MD, Abstract Co-Author: Nothing to Disclose

Laura Jean Horvath MD, Abstract Co-Author: Consultant, Siemens AG

Liane Elizabeth Philpotts MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to determine if screening recall patterns change as tomosynthesis experience increases.

An IRB approved retrospective chart review of screening mammograms with tomosynthesis was performed from 10/1/2011-10/1/2013. The number of screening recalls, types of recalled mammographic abnormalities, recalled abnormality resulting in a cancer diagnosis and numbers of invasive and in situ cancers were recorded over four 6-month periods.

8441 screening mammograms with tomosynthesis were performed over two years at a single tertiary breast center. The overall recall rate was 8.7% (735/8441). Over the four 6-month periods, the recall rates for masses and calcifications did not significantly change (masses: 46/1900, 2.4%; 71/2091, 3.4%; 52/1959, 2.7%, 58/2491, 2.3%; calcifications: 48/1900, 2.5%, 67/2091, 3.2%, 61/1959, 3.1%, 75/2491, 3.0%). The recall rates for architectural distortion (AD) and asymmetries steadily increased over the four periods, and comparing the first and last periods, a statistically significant increase in screening recalls for AD and asymmetries was seen. (AD 5/1900, 0.26%; 15/2091, 0.72%; 20/1959, 1.0%; 25/2491, 1.0%, P=0.0027; asymmetries 66/1900, 3.5%; 78/2091, 3.7%; 84/1959, 4.3%; 123/2491, 4.9%, P=0.0198). The overall cancer detection rate was 5.9/1000 and did not significantly change over the four periods. 6 of 65 recalled architectural distortions resulted in a cancer diagnosis, which at 9.2% was the mammographic abnormality yielding the highest proportion of cancer diagnoses (12/351, 3.4% asymmetries; 11/227, 4.9% masses; 21/272, 7.7% calcifications).

Recalls for architectural distortion at screening mammography with tomosynthesis significantly increase with radiologist experience. Architectural distortion is the mammographic abnormality resulting in the highest proportion of cancer diagnoses. Therefore, radiologists new to interpreting tomosynthesis exams should be aware of the significance of this finding.

Practice habits may change as experience with tomosynthesis is gained.

Durand, M, Hooley, R, Raghu, M, Geisel, J, Andrejeva-Wright, L, Butler, R, Horvath, L, Philpotts, L, Effect of Experience on Tomosynthesis Screening Recall Patterns: Is there a Learning Curve?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015843.html